Individual provider Active NPI

Kylie Martini

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1801582309
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
9610 N Metro Pkwy W
Phoenix, AZ 85051-1402
Phone
(480) 964-2273
Fax
(602) 843-1560
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

9610 N Metro Pkwy W
Phoenix, AZ 85051-1402

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (623) 583-3001

Other practice location 1

650 E Indian School Rd
Phoenix, AZ 85012-1892
Phone (602) 277-5551

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL securerecords.sanford.html Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826001575 AZ Practitioner - Registered Dietitian Or Nutrition Professional 1153860911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Adelante Healthcare, Inc. Current Accepting new patients
Adelante Healthcare, Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

306 E Monroe Ave
Buckeye, AZ 85326
Phone (623) 386-4814

13471 W Cornerstone Blvd
Goodyear, AZ 85395

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

15525 N 83rd Ave
Ste 104
Peoria, AZ 85382

500 W Thomas Rd
Ste 870
Phoenix, AZ 85013
Phone (602) 263-0222

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

9610 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 710-7487

15351 W Bell Rd
Surprise, AZ 85374

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

811 N Tegner St
Ste 113
Wickenburg, AZ 85390

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1801582309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "623-583-3001",
            "fax_number": "623-974-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 N METRO PKWY W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511402",
            "telephone_number": "480-964-2273",
            "fax_number": "602-843-1560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 E Indian School Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850121892",
            "country_code": "US",
            "telephone_number": "602-277-5551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "endpointDescription": "Sanford Secure Records",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "650 E Indian School Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850121892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.